New York City physicians serving high volumes of Medicaid children: who are they and how do they practice?

This study examined, in 1993, the characteristics and practices of New York City physicians who submit large numbers of Medicaid claims for children. Of our sample of 33 physicians, more than 90% were educated outside the United States; fewer than half were board certified or had hospital staff appointments. These physicians saw a clientele who were 98% Medicaid; most visits (82%) were at a time of acute illness. With the rapid advent of mandatory, Medicaid managed care in New York City, and with the large estimated gap in primary care capacity in the inner city, policy questions arise as to whether these physicians should be integrated into managed care plans. If they are not, the question becomes: how will they be replaced?